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Abstract

The report consists of three parts:
global trends in fertility, contraceptive use and unintended
pregnancies; studies of two regions (Africa and Eastern
Europe/Central Asia) and two countries (Nigeria and
Kazakhstan) on the costs of fertility regulation behaviors
and provider attitudes towards contraceptive use. Fertility
levels have declined steadily over the last three decades
but the pace of decline varies among regions. Countries that
have achieved a high level of contraceptive use have reached
a lower fertility level. A gap continues to exist between
actual and desired family size, resulting in unintended
pregnancies. More than one-third of the pregnancies that
occur are unintended and one in five pregnancies ends in
induced abortion. Almost half of all induced abortions are
unsafe, and the proportion of all abortions that are unsafe
have increased during the last decade. Sixty-six percent of
unintended pregnancies occur among women who are not using
any method of contraception. Investing in quality family
planning programs is a cost-effective way to address unmet
need for contraception and reduce the risks of unsafe
abortion, thereby improving maternal health. If
contraception were provided to the 137 million women who
lack access, maternal mortality will decline by 25-35 percent.